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Monday, November 14, 2011

Lessons learned from the UK on the quality of patient engagement

2010, The King’s Fund commissioned an inquiry paper by Picker Institute Europe to review the quality of patient engagement and involvement in primary health care. The paper focuses on patients’ engagement in primary consultations about their own health care, namely the interaction between the general practitioner and patient. Similar to our findings in a recent report, the importance of patient engagement is underscored.

In the UK, efforts have been made to bring patient engagement to the forefront. In the last four years, the NHS has reviewed professional codes, legislation and regulation to propose patient engagement as a requirement for all doctors. Over the past decade, professional education and training for doctors has been revised to highlight communication skills.

Although these changes have resulted in some improvements, the report cites remaining challenges in patient engagement. There are certainly parallels to challenges identified in our previous work, as well as others for future consideration.

Some key challenges highlighted in the report are:

·Workforce skills: There is a need to train professionals in advanced communication skills that aid in understanding patient values, preferences and desire for involvement in decision making. Although developing patient-partnership skills has become a focus for professionals trained during the last decade, these individuals are less likely to be in senior roles in the health care system and are less likely to be influencing a practice model that encourages patient partnerships.

·Practice orientation: There is little awareness of the value for practices to adopt a patient-partnership approach, particularly since there are no specific financial incentives or outcome measures tied to engaging patients.

·Health Literacy: The ability of patients to read, understand and make use of health information available to them in their decision-making can be a barrier to engagement. The strong relationship between health literacy and health inequalities suggest that to improve patient knowledge information must be designed to adjust to patients’ health literacy levels.

·Timefactor: The length of consultation time available is a key barrier to engagement for both physicians and patients.